‘It’s not so much not doing the right things — it’s not doing them at scale’
Photo courtesy of Dr. Ryan Herriot.
In November, Dr. Ryan Herriot made national news when he helped set up an unsanctioned overdose prevention site (OPS) outside Victoria’s Royal Jubilee Hospital. A similar site was set up outside Nanaimo Regional General Hospital that same week.
Both sites were organized and run by a team of volunteers from different backgrounds, including nurses, social workers, and physicians, as well as a number of people who have been directly impacted by the overdose crisis.
Herriot, a specialist in family and addictions medicine, has been working in the field since 2015. In 2016, a year after he finished his family medicine residency, the B.C. government announced a public health emergency in response to the “significant increase in drug-related overdoses and deaths.”
As of September, the B.C. government estimates that 1 749 people have died in 2024 due to toxic drug overdose, bringing the total number of deaths since 2016 to 15 822.
Herriot told the Martlet that he views the pop-up OPS as successful.
“We had lots of supervised consumptions, lots of handing out of Narcan kits and other supplies, [and] connecting people to shelter beds. It was a fantastic success.”
However, he also says there is much more work to do as B.C. moves towards its ninth year of the public health emergency.
“It’s not so much [that we’re] not doing the right things. [We’re] not doing them at scale. So, we have overdose prevention sites, but nowhere near enough,” said Herriot. “It creates this illusion — ‘Hey, we’ve done the thing,’ when we’re not even close to saturation.”
Part of the reason for setting up the unsanctioned OPS was that hospitals in B.C. currently do not have overdose prevention sites of their own. In November, Filter reported that internal Vancouver Island Health Authority (VIHA) documents showed there was a plan to establish an OPS at three hospitals on the island — Royal Jubilee, Nanaimo Regional, and North Island Hospital in Campbell River.
However, the documents show that in April — when the B.C. government announced the recriminalization of drug use in public spaces, including hospitals — this work on establishing OPS was put on hold “based on government direction.”
In an interview with the Martlet, Herriot emphasized how important it is to have overdose prevention services at hospitals, as well as out in the community.
“It’s really to facilitate a safe work environment for everyone who works inside the hospital. Avoiding the use of substances in hospital bathrooms, and so on. And also helping people stay engaged in care,” he said.
In addition to overdose prevention resources, Herriot said that tackling the issue of drug supply is essential to ending the overdose crisis. Two issues that “often get muddled,” he says, are potency and purity.
“The potency of fentanyl means that it’s very challenging for prescriptions to keep up … what we’ve seen is that tools that traditionally worked quite well, like methadone, still work, but nowhere near as effectively in a great many people.”
“The second issue of the supply is it’s uncertain purity … it’s like you went to the liquor store and you bought some beer, and you don’t really know if it’s like 2 per cent alcohol or 40 per cent … and you don’t know if there’s methanol in there or some other contaminants, right? So there’s [actually two] distinct problems with the unregulated supply that often get mixed up.”
For Herriot, the conversation around the overdose crisis has become too politicized in recent years, turning what should be a public health issue into a political one.
“There was this debate in the House of Commons about safer supply as a concept. I had a lot of people get in touch with me and talk in happy tones [about] what a good job [Mental Health and Addictions Minister] Carolyn Bennett did at defending the concept of safer supply,” he said. “My response was, ‘No, you don’t understand. This is terrible. I don’t care how well she did. The very fact that this is being debated on the floor of the House of Commons is a problem.’”
The overdose crisis was a major issue in B.C.’s recent election, in which John Rustad and the BC Conservatives attacked the NDP over “failed experiments” with decriminalization and safe supply, accusing them of “enabling addiction.” Herriot hopes that re-centering the discussion around experts in the field, rather than politicians, will allow the province to take the steps it needs to combat the crisis.
“We need to kind of lower the temperature on this … one of the ways to do that is to have lots of experts in the media on a regular basis.”
